Provider Demographics
NPI:1669852562
Name:KERN, STEPHANIE FRANCES (OTR/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FRANCES
Last Name:KERN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6461 CONROY WINDERMERE RD
Mailing Address - Street 2:APT. 907
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3505
Mailing Address - Country:US
Mailing Address - Phone:770-630-5495
Mailing Address - Fax:
Practice Address - Street 1:5901 SW 74TH ST
Practice Address - Street 2:SUITE 407
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5165
Practice Address - Country:US
Practice Address - Phone:305-668-8917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16788225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist